Monitoring changes in heart rate, as an indicator of the cardiovascular autonomic nervous function, among patients at the sub-acute phase post-brain damage during a physiotherapy session: a preliminary investigation.

OBJECTIVES

To assess cardiovascular autonomic nervous system function of patients post-brain-injury in the sub-acute phase during a physiotherapy session (PTS).

PARTICIPANTS

Fourteen patients post-ischaemic stroke and 11 post-severe traumatic brain injuries.

INTERVENTION

Continuous electrocardiogram recording at rest, during active cycling and during routine PTS.

MAIN OUTCOME MEASURE

Heart rate (HR) and Heart rate variability (HRV) parameters included the standard deviation of all R-R intervals (SDNN), the square root of the mean squared differences of successive differences (RMSSD), the Low-frequency (LF) power, High-frequency (HF) power and the LF/HF ratio.

RESULTS

The median HR at rest was 76 bpm (interquartile range 61-81). Significant increments were noted during activities; median HR during cycling was 93 bpm, during the most intense activity 91 bpm (p-value < 0.001). A significant decline in HRV parameters' median values during cycling and PTS was observed only among patients post-stroke.

CONCLUSIONS

Among patients post-brain injury, HR increased significantly during PTS in different activities and varied positions; therefore, therapists should be aware and monitor HR frequently during training. In addition, HRV values were low at rest and did not respond to activity among patients post-TBI, compared with higher values at rest and some response among patients post-stroke. This may indicate that autonomic impairment post-brain insult is more likely a consequence of central nervous system damage and less likely a result of pre-event cardiovascular illness.